array:23 [
  "pii" => "S1578219010706235"
  "issn" => "15782190"
  "doi" => "10.1016/S1578-2190(10)70623-5"
  "estado" => "S300"
  "fechaPublicacion" => "2010-04-01"
  "aid" => "70623"
  "copyright" => "Academia Española de Dermatología y Venereología and Elsevier España, S.L."
  "copyrightAnyo" => "2010"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "fla"
  "cita" => "Actas Dermosifiliogr. 2010;101:242-7"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 2195
    "formatos" => array:3 [
      "EPUB" => 51
      "HTML" => 1455
      "PDF" => 689
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S1578219010706247"
    "issn" => "15782190"
    "doi" => "10.1016/S1578-2190(10)70624-7"
    "estado" => "S300"
    "fechaPublicacion" => "2010-04-01"
    "aid" => "70624"
    "copyright" => "Academia Española de Dermatología y Venereología and Elsevier España, S.L."
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Actas Dermosifiliogr. 2010;101:248-56"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2693
      "formatos" => array:3 [
        "EPUB" => 37
        "HTML" => 1708
        "PDF" => 948
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Male Androgenetic Alopecia and Cardiovascular Risk Factors&#58; A Case-Control Study"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "248"
          "paginaFinal" => "256"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Alopecia androg&#233;nica masculina y factores de riesgo cardiovascular&#58; estudio de casos y controles"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "S&#46; Arias-Santiago, M&#46;T&#46; Guti&#233;rrez-Salmer&#243;n, L&#46; Castellote-Caballero, A&#46; Buend&#237;a-Eisman, R&#46; Naranjo-Sintes"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "Arias-Santiago"
            ]
            1 => array:2 [
              "nombre" => "M&#46;T&#46;"
              "apellidos" => "Guti&#233;rrez-Salmer&#243;n"
            ]
            2 => array:2 [
              "nombre" => "L&#46;"
              "apellidos" => "Castellote-Caballero"
            ]
            3 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Buend&#237;a-Eisman"
            ]
            4 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Naranjo-Sintes"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219010706247?idApp=UINPBA000044"
    "url" => "/15782190/0000010100000003/v1_201304241518/S1578219010706247/v1_201304241518/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S1578219010706223"
    "issn" => "15782190"
    "doi" => "10.1016/S1578-2190(10)70622-3"
    "estado" => "S300"
    "fechaPublicacion" => "2010-04-01"
    "aid" => "70622"
    "copyright" => "Academia Espa&#241;ola de Dermatolog&#237;a y Venereolog&#237;a and Elsevier Espa&#241;a&#44; S&#46;L&#46;"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Actas Dermosifiliogr. 2010;101:235-41"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2704
      "formatos" => array:3 [
        "EPUB" => 45
        "HTML" => 1728
        "PDF" => 931
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Surgical Treatment of Relapsing Keloid of the Pinna by Fillet Flap"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "235"
          "paginaFinal" => "241"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Tratamiento quir&#250;rgico del queloide recidivante de pabell&#243;n auricular mediante &#171;colgajo en filete&#187;"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "P&#46; Valer&#243;n-Almaz&#225;n, L&#46; Dehesa-Garc&#237;a, J&#46; Vilar-Alejo, J&#46; Dom&#237;nguez-Silva, J&#46; G&#243;mez-Duaso, G&#46; Carretero-Hern&#225;ndez"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "P&#46;"
              "apellidos" => "Valer&#243;n-Almaz&#225;n"
            ]
            1 => array:2 [
              "nombre" => "L&#46;"
              "apellidos" => "Dehesa-Garc&#237;a"
            ]
            2 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Vilar-Alejo"
            ]
            3 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Dom&#237;nguez-Silva"
            ]
            4 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "G&#243;mez-Duaso"
            ]
            5 => array:2 [
              "nombre" => "G&#46;"
              "apellidos" => "Carretero-Hern&#225;ndez"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219010706223?idApp=UINPBA000044"
    "url" => "/15782190/0000010100000003/v1_201304241518/S1578219010706223/v1_201304241518/en/main.assets"
  ]
  "en" => array:15 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
    "titulo" => "Dermatophytoses Due to Anthropophilic Fungi in Cadiz&#44; Spain&#44; Between 1997 and 2008"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "242"
        "paginaFinal" => "247"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "P&#46; Garc&#237;a-Martos, L&#46; Garc&#237;a-Agudo, E&#46; Agudo-P&#233;rez, F&#46; Gil de Sola, M&#46; Linares"
        "autores" => array:5 [
          0 => array:4 [
            "nombre" => "P&#46;"
            "apellidos" => "Garc&#237;a-Martos"
            "email" => array:1 [
              0 => "pigiem1983&#64;yahoo&#46;com&#46;ar"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff1"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">¿</span>"
                "identificador" => "cor1"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "L&#46;"
            "apellidos" => "Garc&#237;a-Agudo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff2"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "E&#46;"
            "apellidos" => "Agudo-P&#233;rez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff3"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "F&#46;"
            "apellidos" => "Gil de Sola"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff1"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "Linares"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff4"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:4 [
          0 => array:3 [
            "entidad" => "Servicio de Microbiolog&#237;a&#44; Hospital Universitario Puerta del Mar&#44; C&#225;diz&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">a</span>"
            "identificador" => "aff1"
          ]
          1 => array:3 [
            "entidad" => "Distrito de Atenci&#243;n Primaria Sierra de C&#225;diz&#44; C&#225;diz&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">b</span>"
            "identificador" => "aff2"
          ]
          2 => array:3 [
            "entidad" => "Unidad de Enfermer&#237;a&#44; Hospital Universitario Puerta del Mar&#44; C&#225;diz&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">c</span>"
            "identificador" => "aff3"
          ]
          3 => array:3 [
            "entidad" => "Servicio de Dermatolog&#237;a&#44; Hospital Universitario Puerta del Mar&#44; C&#225;diz&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">d</span>"
            "identificador" => "aff4"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor1"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Dermatofitosis por hongos antropof&#237;licos en C&#225;diz &#40;1997-2008&#41;"
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2009-06-11"
    "fechaAceptado" => "2009-09-09"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec84721"
          "palabras" => array:5 [
            0 => "Mycosis"
            1 => "Dermatophytosis"
            2 => "<span class="elsevierStyleItalic">Trichophyton rubrum</span>"
            3 => "<span class="elsevierStyleItalic">Trichophyton violaceum</span>"
            4 => "<span class="elsevierStyleItalic">Trichophyton tonsurans</span>"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec84720"
          "palabras" => array:5 [
            0 => "Micosis"
            1 => "Dermatofitosis"
            2 => "<span class="elsevierStyleItalic">Trichophyton rubrum</span>"
            3 => "<span class="elsevierStyleItalic">Trichophyton violaceum</span>"
            4 => "<span class="elsevierStyleItalic">Trichophyton tonsurans</span>"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Background and objectives</span><p class="elsevierStyleSimplePara elsevierViewall">Cutaneous fungal infections are a major public health problem&#46; The distribution of the dermatophytoses varies between countries and geographical areas&#46; The aim of this study was to determine the incidence&#44; epidemiology&#44; etiology&#44; and clinical course of the dermatophytoses caused by anthropophilic fungi in Cadiz&#44; Spain&#44; over the past 12 years&#46;</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p class="elsevierStyleSimplePara elsevierViewall">The study&#44; conducted between 1997 and 2008&#44; included 2235 samples from lesions of the skin&#44; hair&#44; and nails of 2220 patients with a clinical suspicion of mycosis&#46; Samples were examined by microscopy using potassium hydroxide and were cultured on mycological media&#46; The dermatophytes were identified by their macroscopic and microscopic characteristics&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Cultures were positive in 283 cases &#40;12&#46;7&#37;&#41;&#46; Anthropophilic dermatophytes &#40;53&#46;3&#37;&#41; were more common than zoophilic &#40;41&#46;3&#37;&#41; and geophilic &#40;5&#46;3&#37;&#41; dermatophytes&#46; <span class="elsevierStyleItalic">Trichophyton rubrum</span> &#40;38&#46;2&#37;&#41; was the predominant pathogen isolated&#44; followed by <span class="elsevierStyleItalic">Microsporum canis</span> &#40;22&#46;3&#37;&#41; and <span class="elsevierStyleItalic">Trichophyton mentagrophytes</span> &#40;15&#46;5&#37;&#41;&#46; Five other species of anthropophilic fungi were identified&#58; <span class="elsevierStyleItalic">Trichophyton tonsurans</span> &#40;5&#46;6&#37;&#41;&#44; <span class="elsevierStyleItalic">Trichophyton violaceum</span> &#40;4&#46;9&#37;&#41;&#44; <span class="elsevierStyleItalic">Epidermophyton floccosum</span> &#40;2&#46;8&#37;&#41;&#44; <span class="elsevierStyleItalic">Trichophyton soudanense</span> &#40;1&#46;0&#37;&#41;&#44; and <span class="elsevierStyleItalic">Trichophyton schoenleinii</span> &#40;0&#46;7&#37;&#41;&#46; Infections caused by the anthropophilic fungi included tinea unguium &#40;29&#46;1&#37;&#41;&#44; tinea corporis &#40;25&#46;8&#37;&#41;&#44; tinea pedis &#40;19&#46;2&#37;&#41;&#44; tinea cruris &#40;11&#46;9&#37;&#41;&#44; tinea capitis &#40;5&#46;3&#37;&#41;&#44; and tinea faciei &#40;3&#46;3&#37;&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The principal fungus responsible for dermatomycosis in Cadiz was <span class="elsevierStyleItalic">T&#46; rubrum&#44;</span> and its incidence has been rising since 2000&#46; The prevalence of other anthropophilic fungi&#44; such as <span class="elsevierStyleItalic">T&#46; tonsurans</span> and <span class="elsevierStyleItalic">T&#46; violaceum</span>&#44; has increased&#44; though this is not directly related to immigration&#46; <span class="elsevierStyleItalic">E&#46; floccosum</span>&#44; <span class="elsevierStyleItalic">T&#46; soudanense</span>&#44; and <span class="elsevierStyleItalic">T&#46; schoenleinii</span> are isolated occasionally&#46;</p>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n y objetivos</span><p class="elsevierStyleSimplePara elsevierViewall">Las infecciones cut&#225;neas producidas por hongos constituyen un importante problema de salud p&#250;blica&#46; La distribuci&#243;n de las dermatofitosis var&#237;a en diferentes pa&#237;ses y &#225;reas geogr&#225;ficas&#46; El objetivo de este estudio ha sido determinar la epidemiolog&#237;a&#44; etiolog&#237;a y evoluci&#243;n de las dermatofitosis por hongos antropof&#237;licos en C&#225;diz durante los &#250;ltimos 12 a&#241;os&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">El estudio se realiz&#243; de 1997-2008 sobre 2&#46;235 muestras de lesiones de piel&#44; pelo y u&#241;as de 2&#46;220 pacientes con sospecha cl&#237;nica de micosis&#46; Las muestras fueron analizadas mediante examen microsc&#243;pico con hidr&#243;xido pot&#225;sico y cultivo en medios micol&#243;gicos&#46; Los dermatofitos se identificaron de acuerdo con las caracter&#237;sticas macrosc&#243;picas y microsc&#243;picas&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">El cultivo fue positivo en 283 muestras &#40;12&#44;7&#37;&#41;&#46; Los dermatofitos antropof&#237;licos &#40;53&#44;3&#37;&#41; predominaron sobre los zoof&#237;licos &#40;41&#44;3&#37;&#41; y geof&#237;licos &#40;5&#44;3&#37;&#41;&#46; <span class="elsevierStyleItalic">Trichophyton rubrum</span> &#40;38&#44;2&#37;&#41; fue el pat&#243;geno m&#225;s frecuente&#44; seguido de <span class="elsevierStyleItalic">Microsporum canis</span> &#40;22&#44;3&#37;&#41; y <span class="elsevierStyleItalic">Trichophyton mentagrophytes</span> &#40;15&#44;5&#37;&#41;&#46; Se identificaron otras cinco especies de hongos antropof&#237;licos&#58; <span class="elsevierStyleItalic">T&#46; tonsurans</span> &#40;5&#44;6&#37;&#41;&#44; <span class="elsevierStyleItalic">T&#46; violaceum</span> &#40;4&#44;9&#37;&#41;&#44; <span class="elsevierStyleItalic">Epidermophyton floccosum</span> &#40;2&#44;8&#37;&#41;&#44; <span class="elsevierStyleItalic">T&#46; soudanense</span> &#40;1&#44;0&#37;&#41; y <span class="elsevierStyleItalic">T&#46; schoenleinii</span> &#40;0&#44;7&#37;&#41;&#46; Las infecciones por hongos antropof&#237;licos fueron onicomicosis &#40;29&#44;1&#37;&#41;&#44; ti&#241;a corporal &#40;25&#44;8&#37;&#41;&#44; ti&#241;a del pie &#40;19&#44;2&#37;&#41;&#44; ti&#241;a crural &#40;11&#44;9&#37;&#41;&#44; ti&#241;a del cuero cabelludo &#40;5&#44;3&#37;&#41; y ti&#241;a facial &#40;3&#44;3&#37;&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">El principal responsable de dermatofitosis en C&#225;diz es <span class="elsevierStyleItalic">Trichophyton rubrum</span>&#46; Su incidencia es ascendente desde el a&#241;o 2000&#46; Otros hongos antropof&#237;licos como <span class="elsevierStyleItalic">T&#46; tonsurans</span> y <span class="elsevierStyleItalic">T&#46; violaceum</span> son cada vez m&#225;s prevalentes&#44; aunque no est&#225;n directamente relacionados con la inmigraci&#243;n&#46; <span class="elsevierStyleItalic">Epidermophyton floccosum</span>&#44; <span class="elsevierStyleItalic">T&#46; soudanense</span> y <span class="elsevierStyleItalic">T&#46; schoenleinii</span> se a&#237;slan ocasionalmente&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:1 [
          "bibliografiaReferencia" => array:31 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiological trends in skin mycoses worldwide"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "B&#46; Havlickova"
                            1 => "V&#46;A&#46; Czaika"
                            2 => "M&#46; Friedrich"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1439-0507.2008.01606.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Mycoses"
                        "fecha" => "2008"
                        "volumen" => "51"
                        "paginaInicial" => "2"
                        "paginaFinal" => "15"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18783559"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dermatophytoses in Monterrey&#44; M&#233;xico"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "O&#46; Welsh"
                            1 => "E&#46; Welsh"
                            2 => "J&#46; Ocampo-Candiani"
                            3 => "M&#46; Gomez"
                            4 => "L&#46; Vera-Cabrera"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1439-0507.2006.01199.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Mycoses"
                        "fecha" => "2006"
                        "volumen" => "49"
                        "paginaInicial" => "119"
                        "paginaFinal" => "123"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16466445"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estudio epidemiol&#243;gico sobre las dermatofitosis en Espa&#241;a &#40;abril-junio 2001&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Monz&#243;n de la Torre"
                            1 => "M&#46; Cuenca-Estrella"
                            2 => "J&#46;L&#46; Rodr&#237;guez-Tudela"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Enferm Infec Microbiol Clin"
                        "fecha" => "2003"
                        "volumen" => "21"
                        "paginaInicial" => "477"
                        "paginaFinal" => "483"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estudio etiol&#243;gico y epidemiol&#243;gico de las dermatofitosis en Navarra &#40;Espa&#241;a&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Maz&#243;n"
                            1 => "S&#46; Salvo"
                            2 => "R&#46; Vives"
                            3 => "A&#46; Valcayo"
                            4 => "M&#46;A&#46; Sabalza"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Iberoam Micol"
                        "fecha" => "1997"
                        "volumen" => "14"
                        "paginaInicial" => "65"
                        "paginaFinal" => "68"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16854174"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estudio cl&#237;nico y epidemiol&#243;gico de las dermatofitosis en una Zona B&#225;sica de Salud de Ja&#233;n &#40;Espa&#241;a&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Padilla"
                            1 => "A&#46; Sampedro"
                            2 => "P&#46; Sampedro"
                            3 => "V&#46; Delgado"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Iberoam Micol"
                        "fecha" => "2002"
                        "volumen" => "19"
                        "paginaInicial" => "36"
                        "paginaFinal" => "39"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12716229"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estudio de las dermatofitosis en Lanzarote &#40;1995-1999&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "E&#46; Piqu&#233;"
                            1 => "R&#46; Fust&#233;"
                            2 => "R&#46; Copado"
                            3 => "J&#46; Noguera"
                            4 => "P&#46; Ramis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Iberoam Micol"
                        "fecha" => "2002"
                        "volumen" => "19"
                        "paginaInicial" => "165"
                        "paginaFinal" => "168"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12825996"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dermatofitos aislados en muestras cl&#237;nicas&#46; Estudio de 5 a&#241;os en Zaragoza"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "B&#46; Fortu&#241;o"
                            1 => "L&#46; Torres"
                            2 => "E&#46; Simal"
                            3 => "A&#46; Seoane"
                            4 => "J&#46;A&#46; Uriel"
                            5 => "C&#46; Santacruz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Enferm Infecc Microbiol Clin"
                        "fecha" => "1997"
                        "volumen" => "15"
                        "paginaInicial" => "536"
                        "paginaFinal" => "539"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9580210"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estudio epidemiol&#243;gico de las dermatofitosis en C&#243;rdoba &#40;1991-1993&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;C&#46; Fern&#225;ndez Rold&#225;n"
                            1 => "A&#46; V&#233;lez Garc&#237;a-Nieto"
                            2 => "A&#46; Morillo-Velarde Chiclana"
                            3 => "M&#46;J&#46; Linares Sicilia"
                            4 => "M&#46; Casal Rom&#225;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Actas Dermatosifiliogr"
                        "fecha" => "1994"
                        "volumen" => "85"
                        "paginaInicial" => "670"
                        "paginaFinal" => "672"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Contribuci&#243;n de laboratorio al estudio de las dermatofitosis de Madrid&#58; un a&#241;o de experiencia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46; C ach&#243;n"
                            1 => "J&#46;I&#46; Al&#243;s"
                            2 => "C&#46; Madariaga"
                            3 => "J&#46;L&#46; Aparicio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Enferm Infecc Microbiol Clin"
                        "fecha" => "1988"
                        "volumen" => "6"
                        "paginaInicial" => "401"
                        "paginaFinal" => "405"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Contribuci&#243;n al estudio etiol&#243;gico y epidemiol&#243;gico de las ti&#241;as en Valencia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;L&#46; S&#225;nchez Carazo"
                            1 => "J&#46;J&#46; Vilata Corell"
                            2 => "J&#46; de la Cuadra"
                            3 => "A&#46; Aliaga Boniche"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "1983"
                        "volumen" => "74"
                        "paginaInicial" => "211"
                        "paginaFinal" => "213"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estudio micol&#243;gico de las ti&#241;as en la provincia de Granada &#40;1971-1980&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;M&#46; Ure&#241;a Escribano"
                            1 => "V&#46; Delgado Florencio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "1982"
                        "volumen" => "73"
                        "paginaInicial" => "9"
                        "paginaFinal" => "12"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Contribuci&#243;n al estudio epidemiol&#243;gico de las micosis superficiales en Zaragoza"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "E&#46; Simal"
                            1 => "M&#46;P&#46; Moreno"
                            2 => "N&#46; Porta"
                            3 => "M&#46;T&#46; Gracia"
                            4 => "C&#46; Coscojuela"
                            5 => "F&#46;J&#46; Carapeto"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "1985"
                        "volumen" => "76"
                        "paginaInicial" => "275"
                        "paginaFinal" => "282"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Micolog&#237;a dermatol&#243;gica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "V&#46; Crespo Erchiga"
                            1 => "V&#46; Delgado Florencio"
                            2 => "S&#46; Mart&#237;nez Garc&#237;a"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2006"
                        "editorial" => "MRA"
                        "editorialLocalizacion" => "Barcelona"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiological survey of dermatophytosis in Tehran&#44; Iran&#44; from 2000 to 2005"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46; Bassiri-Jahromi"
                            1 => "A&#46;A&#46; Khaksari"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Indian J Dermatol Venereol Leprol"
                        "fecha" => "2009"
                        "volumen" => "75"
                        "paginaInicial" => "142"
                        "paginaFinal" => "147"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19293500"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dermatophyte infections in Cairo&#44; Egypt"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46;M&#46; Zaki"
                            1 => "N&#46; Ibrahim"
                            2 => "K&#46; Aoyama"
                            3 => "Y&#46;M&#46; Shetaia"
                            4 => "K&#46; Abdel-Ghany"
                            5 => "Y&#46; Mikami"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11046-008-9165-5"
                      "Revista" => array:6 [
                        "tituloSerie" => "Mycopathologia"
                        "fecha" => "2009"
                        "volumen" => "167"
                        "paginaInicial" => "133"
                        "paginaFinal" => "137"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18972221"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology of dermatophytoses in a rural community in Eastern Nigeria and review of literature from Africa"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46;C&#46; Ngwogu"
                            1 => "T&#46;V&#46; Otokunefor"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11046-007-9038-3"
                      "Revista" => array:6 [
                        "tituloSerie" => "Mycopathologia"
                        "fecha" => "2007"
                        "volumen" => "164"
                        "paginaInicial" => "149"
                        "paginaFinal" => "158"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17657581"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cambios en la epidemiolog&#237;a de las ti&#241;as&#46; Aspectos particulares de Andaluc&#237;a"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "V&#46; Delgado Florencio"
                            1 => "J&#46; Abad Romero-Balmas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Iberoam Micol"
                        "fecha" => "1999"
                        "volumen" => "16"
                        "paginaInicial" => "3"
                        "paginaFinal" => "6"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cambios epidemiol&#243;gicos observados en un decenio en las dermatofitosis del hospital universitario 12 de Octubre de Madrid&#58; nuevas especies emergentes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Del Palacio"
                            1 => "M&#46;S&#46; Cu&#233;tara"
                            2 => "A&#46; Valle"
                            3 => "A&#46; Gonz&#225;lez"
                            4 => "I&#46; Almondarain"
                            5 => "M&#46;J&#46; Ramos Castillo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Iberoam Micol"
                        "fecha" => "1999"
                        "volumen" => "16"
                        "paginaInicial" => "101"
                        "paginaFinal" => "106"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18473578"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estudio epidemiol&#243;gico de las dermatofitosis en las &#225;reas sur y suroeste de la provincia de Huelva &#40;1989-1995&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Herrera Saval"
                            1 => "J&#46;A&#46; Reposo Maestre"
                            2 => "A&#46; de la Iglesia"
                            3 => "F&#46; Ortiz Morcillo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Actas Dermatosifiliogr"
                        "fecha" => "1997"
                        "volumen" => "88"
                        "paginaInicial" => "179"
                        "paginaFinal" => "183"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Multicenter study of dermatophyte distribution in the metropolitan area of Barcelona &#40;Catalonia&#44; Spain&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;M&#46; Torres-Rodr&#237;guez"
                            1 => "J&#46; Balaguer-Meler"
                            2 => "M&#46; Vent&#237;n-Hern&#225;ndez"
                            3 => "N&#46; Mart&#237;n-Casabona"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Mycopathologia"
                        "fecha" => "1986"
                        "volumen" => "93"
                        "paginaInicial" => "95"
                        "paginaFinal" => "97"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3713794"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dermatofitos y dermatofitosis en C&#243;rdoba &#40;Espa&#241;a&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Casal"
                            1 => "M&#46;J&#46; Linares"
                            2 => "J&#46;C&#46; Fern&#225;ndez"
                            3 => "F&#46; Sol&#237;s"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Enferm Infec Microbiol Clin"
                        "fecha" => "1991"
                        "volumen" => "9"
                        "paginaInicial" => "491"
                        "paginaFinal" => "494"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Predominio de las especies zoof&#237;licas en los dermatofitos aislados en Zaragoza"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46;C&#46; Rubio Calvo"
                            1 => "A&#46; Rezusta L&#243;pez"
                            2 => "J&#46; Gil Tom&#225;s"
                            3 => "M&#46;R&#46; Bueno Ib&#225;&#241;ez"
                            4 => "R&#46; G&#243;mez Lus"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Iberoam Micol"
                        "fecha" => "1986"
                        "volumen" => "5"
                        "paginaInicial" => "11"
                        "paginaFinal" => "20"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estudio de las dermatofitosis en el &#225;rea sanitaria del hospital provincial de Pontevedra"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; Losada Campa"
                            1 => "F&#46; Mu&#241;oz Aguin"
                            2 => "D&#46; Formoso Tojo"
                            3 => "C&#46; Torre Fraga"
                            4 => "M&#46; Pulian Morais"
                            5 => "M&#46; Cruces Prado"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Actas Dermatosifiliogr"
                        "fecha" => "1994"
                        "volumen" => "85"
                        "paginaInicial" => "667"
                        "paginaFinal" => "669"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Contribuci&#243;n al estudio epidemiol&#243;gico de las dermatofitosis en la provincia de Toledo"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "D&#46; Garc&#237;a Almagro"
                            1 => "S&#46; Brea"
                            2 => "R&#46; Orueta"
                            3 => "F&#46; L&#243;pez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Actas Dermatosifiliogr"
                        "fecha" => "1989"
                        "volumen" => "80"
                        "paginaInicial" => "443"
                        "paginaFinal" => "446"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estudio de las dermatofitosis en Madrid durante una d&#233;cada &#40;1978-1987&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Del Palacio"
                            1 => "F&#46; Gonz&#225;lez"
                            2 => "P&#46; Moreno"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Iberoam Micol"
                        "fecha" => "1989"
                        "volumen" => "6"
                        "paginaInicial" => "86"
                        "paginaFinal" => "101"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Review of dermatophytoses in Galicia from 1951 to 1987"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Pereiro Miguens"
                            1 => "M&#46; Pereiro"
                            2 => "M&#46; Pereiro Jr"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Mycopathologia"
                        "fecha" => "1991"
                        "volumen" => "113"
                        "paginaInicial" => "65"
                        "paginaFinal" => "78"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2034261"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estudio epidemiol&#243;gico sobre las dermatofitosis en Espa&#241;a &#40;abril-junio 2001&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Monz&#243;n de la Torre"
                            1 => "M&#46; Cuenca-Estrella"
                            2 => "J&#46;L&#46; Rodr&#237;guez-Tudela"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Enferm Infecc Microbiol Clin"
                        "fecha" => "2003"
                        "volumen" => "21"
                        "paginaInicial" => "477"
                        "paginaFinal" => "483"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14572379"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib28"
              "etiqueta" => "28&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dermatophyte infections in patients attending a tertiary care hospital in northern Italy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46; Asticcioli"
                            1 => "A&#46; Di Silverio"
                            2 => "L&#46; Sacco"
                            3 => "I&#46; Fusi"
                            4 => "L&#46; Vincenti"
                            5 => "E&#46; Romero"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "New Microbiol"
                        "fecha" => "2008"
                        "volumen" => "31"
                        "paginaInicial" => "543"
                        "paginaFinal" => "548"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19123311"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib29"
              "etiqueta" => "29&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Trichophyton violaceum&#58; un pat&#243;geno emergente"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "T&#46; Juncosa"
                            1 => "P&#46; Aguilera"
                            2 => "A&#46; Ja&#233;n"
                            3 => "A&#46; Vicente"
                            4 => "A&#46;C&#46; Aguilar"
                            5 => "V&#46; Fumad&#243;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Enferm Infecc Microbiol Clin"
                        "fecha" => "2008"
                        "volumen" => "26"
                        "paginaInicial" => "502"
                        "paginaFinal" => "504"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19094864"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib30"
              "etiqueta" => "30&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dermatofitosis por Microsporum gypseum&#58; descripci&#243;n de ocho casos y revisi&#243;n de la literatura"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "P&#46; Garc&#237;a-Martos"
                            1 => "J&#46; Ruiz-Arag&#243;n"
                            2 => "L&#46; Garc&#237;a-Agudo"
                            3 => "M&#46; Linares"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Iberoam Micol"
                        "fecha" => "2004"
                        "volumen" => "21"
                        "paginaInicial" => "147"
                        "paginaFinal" => "149"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15709790"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib31"
              "etiqueta" => "31&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Case of onychomycosis caused by Microsporum racemosum"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P&#46; Garc&#237;a-Martos"
                            1 => "J&#46; Gen&#233;"
                            2 => "M&#46; Sol&#233;"
                            3 => "J&#46; Mira"
                            4 => "R&#46; Ruiz-Henestrosa"
                            5 => "J&#46; Guarro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Microbiol"
                        "fecha" => "1999"
                        "volumen" => "37"
                        "paginaInicial" => "258"
                        "paginaFinal" => "260"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9854108"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15782190/0000010100000003/v1_201304241518/S1578219010706235/v1_201304241518/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "6155"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original Articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010100000003/v1_201304241518/S1578219010706235/v1_201304241518/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219010706235?idApp=UINPBA000044"
]
Compartir
Información de la revista
Vol. 101. Núm. 3.
Páginas 242-247 (abril 2010)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 101. Núm. 3.
Páginas 242-247 (abril 2010)
Original Article
Acceso a texto completo
Dermatophytoses Due to Anthropophilic Fungi in Cadiz, Spain, Between 1997 and 2008
Dermatofitosis por hongos antropofílicos en Cádiz (1997-2008)
Visitas
5810
P. García-Martosa,
Autor para correspondencia
pigiem1983@yahoo.com.ar

Corresponding author.
, L. García-Agudob, E. Agudo-Pérezc, F. Gil de Solaa, M. Linaresd
a Servicio de Microbiología, Hospital Universitario Puerta del Mar, Cádiz, Spain
b Distrito de Atención Primaria Sierra de Cádiz, Cádiz, Spain
c Unidad de Enfermería, Hospital Universitario Puerta del Mar, Cádiz, Spain
d Servicio de Dermatología, Hospital Universitario Puerta del Mar, Cádiz, Spain
Este artículo ha recibido
Información del artículo
Abstract
Background and objectives

Cutaneous fungal infections are a major public health problem. The distribution of the dermatophytoses varies between countries and geographical areas. The aim of this study was to determine the incidence, epidemiology, etiology, and clinical course of the dermatophytoses caused by anthropophilic fungi in Cadiz, Spain, over the past 12 years.

Material and methods

The study, conducted between 1997 and 2008, included 2235 samples from lesions of the skin, hair, and nails of 2220 patients with a clinical suspicion of mycosis. Samples were examined by microscopy using potassium hydroxide and were cultured on mycological media. The dermatophytes were identified by their macroscopic and microscopic characteristics.

Results

Cultures were positive in 283 cases (12.7%). Anthropophilic dermatophytes (53.3%) were more common than zoophilic (41.3%) and geophilic (5.3%) dermatophytes. Trichophyton rubrum (38.2%) was the predominant pathogen isolated, followed by Microsporum canis (22.3%) and Trichophyton mentagrophytes (15.5%). Five other species of anthropophilic fungi were identified: Trichophyton tonsurans (5.6%), Trichophyton violaceum (4.9%), Epidermophyton floccosum (2.8%), Trichophyton soudanense (1.0%), and Trichophyton schoenleinii (0.7%). Infections caused by the anthropophilic fungi included tinea unguium (29.1%), tinea corporis (25.8%), tinea pedis (19.2%), tinea cruris (11.9%), tinea capitis (5.3%), and tinea faciei (3.3%).

Conclusions

The principal fungus responsible for dermatomycosis in Cadiz was T. rubrum, and its incidence has been rising since 2000. The prevalence of other anthropophilic fungi, such as T. tonsurans and T. violaceum, has increased, though this is not directly related to immigration. E. floccosum, T. soudanense, and T. schoenleinii are isolated occasionally.

Keywords:
Mycosis
Dermatophytosis
Trichophyton rubrum
Trichophyton violaceum
Trichophyton tonsurans
Resumen
Introducción y objetivos

Las infecciones cutáneas producidas por hongos constituyen un importante problema de salud pública. La distribución de las dermatofitosis varía en diferentes países y áreas geográficas. El objetivo de este estudio ha sido determinar la epidemiología, etiología y evolución de las dermatofitosis por hongos antropofílicos en Cádiz durante los últimos 12 años.

Material y métodos

El estudio se realizó de 1997-2008 sobre 2.235 muestras de lesiones de piel, pelo y uñas de 2.220 pacientes con sospecha clínica de micosis. Las muestras fueron analizadas mediante examen microscópico con hidróxido potásico y cultivo en medios micológicos. Los dermatofitos se identificaron de acuerdo con las características macroscópicas y microscópicas.

Resultados

El cultivo fue positivo en 283 muestras (12,7%). Los dermatofitos antropofílicos (53,3%) predominaron sobre los zoofílicos (41,3%) y geofílicos (5,3%). Trichophyton rubrum (38,2%) fue el patógeno más frecuente, seguido de Microsporum canis (22,3%) y Trichophyton mentagrophytes (15,5%). Se identificaron otras cinco especies de hongos antropofílicos: T. tonsurans (5,6%), T. violaceum (4,9%), Epidermophyton floccosum (2,8%), T. soudanense (1,0%) y T. schoenleinii (0,7%). Las infecciones por hongos antropofílicos fueron onicomicosis (29,1%), tiña corporal (25,8%), tiña del pie (19,2%), tiña crural (11,9%), tiña del cuero cabelludo (5,3%) y tiña facial (3,3%).

Conclusiones

El principal responsable de dermatofitosis en Cádiz es Trichophyton rubrum. Su incidencia es ascendente desde el año 2000. Otros hongos antropofílicos como T. tonsurans y T. violaceum son cada vez más prevalentes, aunque no están directamente relacionados con la inmigración. Epidermophyton floccosum, T. soudanense y T. schoenleinii se aíslan ocasionalmente.

Palabras clave:
Micosis
Dermatofitosis
Trichophyton rubrum
Trichophyton violaceum
Trichophyton tonsurans
El Texto completo está disponible en PDF
References
[1.]
B. Havlickova, V.A. Czaika, M. Friedrich.
Epidemiological trends in skin mycoses worldwide.
[2.]
O. Welsh, E. Welsh, J. Ocampo-Candiani, M. Gomez, L. Vera-Cabrera.
Dermatophytoses in Monterrey, México.
[3.]
A. Monzón de la Torre, M. Cuenca-Estrella, J.L. Rodríguez-Tudela.
Estudio epidemiológico sobre las dermatofitosis en España (abril-junio 2001).
Enferm Infec Microbiol Clin, 21 (2003), pp. 477-483
[4.]
A. Mazón, S. Salvo, R. Vives, A. Valcayo, M.A. Sabalza.
Estudio etiológico y epidemiológico de las dermatofitosis en Navarra (España).
Rev Iberoam Micol, 14 (1997), pp. 65-68
[5.]
A. Padilla, A. Sampedro, P. Sampedro, V. Delgado.
Estudio clínico y epidemiológico de las dermatofitosis en una Zona Básica de Salud de Jaén (España).
Rev Iberoam Micol, 19 (2002), pp. 36-39
[6.]
E. Piqué, R. Fusté, R. Copado, J. Noguera, P. Ramis.
Estudio de las dermatofitosis en Lanzarote (1995-1999).
Rev Iberoam Micol, 19 (2002), pp. 165-168
[7.]
B. Fortuño, L. Torres, E. Simal, A. Seoane, J.A. Uriel, C. Santacruz.
Dermatofitos aislados en muestras clínicas. Estudio de 5 años en Zaragoza.
Enferm Infecc Microbiol Clin, 15 (1997), pp. 536-539
[8.]
J.C. Fernández Roldán, A. Vélez García-Nieto, A. Morillo-Velarde Chiclana, M.J. Linares Sicilia, M. Casal Román.
Estudio epidemiológico de las dermatofitosis en Córdoba (1991-1993).
Actas Dermatosifiliogr, 85 (1994), pp. 670-672
[9.]
J. C achón, J.I. Alós, C. Madariaga, J.L. Aparicio.
Contribución de laboratorio al estudio de las dermatofitosis de Madrid: un año de experiencia.
Enferm Infecc Microbiol Clin, 6 (1988), pp. 401-405
[10.]
J.L. Sánchez Carazo, J.J. Vilata Corell, J. de la Cuadra, A. Aliaga Boniche.
Contribución al estudio etiológico y epidemiológico de las tiñas en Valencia.
Actas Dermosifiliogr, 74 (1983), pp. 211-213
[11.]
J.M. Ureña Escribano, V. Delgado Florencio.
Estudio micológico de las tiñas en la provincia de Granada (1971-1980).
Actas Dermosifiliogr, 73 (1982), pp. 9-12
[12.]
E. Simal, M.P. Moreno, N. Porta, M.T. Gracia, C. Coscojuela, F.J. Carapeto.
Contribución al estudio epidemiológico de las micosis superficiales en Zaragoza.
Actas Dermosifiliogr, 76 (1985), pp. 275-282
[13.]
V. Crespo Erchiga, V. Delgado Florencio, S. Martínez García.
Micología dermatológica.
MRA, (2006),
[14.]
S. Bassiri-Jahromi, A.A. Khaksari.
Epidemiological survey of dermatophytosis in Tehran, Iran, from 2000 to 2005.
Indian J Dermatol Venereol Leprol, 75 (2009), pp. 142-147
[15.]
S.M. Zaki, N. Ibrahim, K. Aoyama, Y.M. Shetaia, K. Abdel-Ghany, Y. Mikami.
Dermatophyte infections in Cairo, Egypt.
Mycopathologia, 167 (2009), pp. 133-137
[16.]
A.C. Ngwogu, T.V. Otokunefor.
Epidemiology of dermatophytoses in a rural community in Eastern Nigeria and review of literature from Africa.
Mycopathologia, 164 (2007), pp. 149-158
[17.]
V. Delgado Florencio, J. Abad Romero-Balmas.
Cambios en la epidemiología de las tiñas. Aspectos particulares de Andalucía.
Rev Iberoam Micol, 16 (1999), pp. 3-6
[18.]
A. Del Palacio, M.S. Cuétara, A. Valle, A. González, I. Almondarain, M.J. Ramos Castillo, et al.
Cambios epidemiológicos observados en un decenio en las dermatofitosis del hospital universitario 12 de Octubre de Madrid: nuevas especies emergentes.
Rev Iberoam Micol, 16 (1999), pp. 101-106
[19.]
A. Herrera Saval, J.A. Reposo Maestre, A. de la Iglesia, F. Ortiz Morcillo.
Estudio epidemiológico de las dermatofitosis en las áreas sur y suroeste de la provincia de Huelva (1989-1995).
Actas Dermatosifiliogr, 88 (1997), pp. 179-183
[20.]
J.M. Torres-Rodríguez, J. Balaguer-Meler, M. Ventín-Hernández, N. Martín-Casabona.
Multicenter study of dermatophyte distribution in the metropolitan area of Barcelona (Catalonia, Spain).
Mycopathologia, 93 (1986), pp. 95-97
[21.]
M. Casal, M.J. Linares, J.C. Fernández, F. Solís.
Dermatofitos y dermatofitosis en Córdoba (España).
Enferm Infec Microbiol Clin, 9 (1991), pp. 491-494
[22.]
M.C. Rubio Calvo, A. Rezusta López, J. Gil Tomás, M.R. Bueno Ibáñez, R. Gómez Lus.
Predominio de las especies zoofílicas en los dermatofitos aislados en Zaragoza.
Rev Iberoam Micol, 5 (1986), pp. 11-20
[23.]
A. Losada Campa, F. Muñoz Aguin, D. Formoso Tojo, C. Torre Fraga, M. Pulian Morais, M. Cruces Prado.
Estudio de las dermatofitosis en el área sanitaria del hospital provincial de Pontevedra.
Actas Dermatosifiliogr, 85 (1994), pp. 667-669
[24.]
D. García Almagro, S. Brea, R. Orueta, F. López.
Contribución al estudio epidemiológico de las dermatofitosis en la provincia de Toledo.
Actas Dermatosifiliogr, 80 (1989), pp. 443-446
[25.]
A. Del Palacio, F. González, P. Moreno.
Estudio de las dermatofitosis en Madrid durante una década (1978-1987).
Rev Iberoam Micol, 6 (1989), pp. 86-101
[26.]
M. Pereiro Miguens, M. Pereiro, M. Pereiro Jr.
Review of dermatophytoses in Galicia from 1951 to 1987.
Mycopathologia, 113 (1991), pp. 65-78
[27.]
A. Monzón de la Torre, M. Cuenca-Estrella, J.L. Rodríguez-Tudela.
Estudio epidemiológico sobre las dermatofitosis en España (abril-junio 2001).
Enferm Infecc Microbiol Clin, 21 (2003), pp. 477-483
[28.]
S. Asticcioli, A. Di Silverio, L. Sacco, I. Fusi, L. Vincenti, E. Romero.
Dermatophyte infections in patients attending a tertiary care hospital in northern Italy.
New Microbiol, 31 (2008), pp. 543-548
[29.]
T. Juncosa, P. Aguilera, A. Jaén, A. Vicente, A.C. Aguilar, V. Fumadó.
Trichophyton violaceum: un patógeno emergente.
Enferm Infecc Microbiol Clin, 26 (2008), pp. 502-504
[30.]
P. García-Martos, J. Ruiz-Aragón, L. García-Agudo, M. Linares.
Dermatofitosis por Microsporum gypseum: descripción de ocho casos y revisión de la literatura.
Rev Iberoam Micol, 21 (2004), pp. 147-149
[31.]
P. García-Martos, J. Gené, M. Solé, J. Mira, R. Ruiz-Henestrosa, J. Guarro.
Case of onychomycosis caused by Microsporum racemosum.
J Clin Microbiol, 37 (1999), pp. 258-260
Copyright © 2010. Academia Española de Dermatología y Venereología and Elsevier España, S.L.
Descargar PDF
Idiomas
Actas Dermo-Sifiliográficas
Opciones de artículo
Herramientas
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?